Successful regimen for medical termination of pregnancy in the first trimester is -

Ans is 'd' i.e.,All of the above Medical methods of first-trimester abortion o Mifepristone (RU-486) and Misoprostol: Mifepristone an analog of progestin (norethindrone) acts as an antagonist, blocking the effect of natural progesterone. Addition of low-dose prostaglandins (PGE1) improves the efficiency of first-trimester abortion. It is effective for up to 63 days and is highly successful when used within 49 days of gestation. o PROTOCOL: 200 mg of mifepristone orally is given on day 1. On day 3, misoprostol (PGE1) 400 g orally or 800 g vaginally is given. The patient remains in the clinic for 4 hours during which expulsion of the conceptus (95%) often occurs. The patient is reexamined after 10-14 days. Complete abortion is observed in 95%, incomplete in about 2% of cases and about 1% do not respond at all. Oral mifepristone 200 mg (1 tab) with vaginal misoprostol 800 g (4 tabs, 200 g each) after 6-48 hours is equally effective. This combipack (1+4) is approved by DGHS, Government of India for MTP up to 63 days of pregnancy. Medical methods are safe, effective, noninvasive and have minimal or no complications. Ref 2 - Comparison of Common Medical Abortion Regimens Common Regimens Overall Success Rate (%) Advantages and Disadvantages Gestational Age Mifepristone 600 mg orally, followed by misoprostol 400 micrograms orally 48 hours later (regimen approved by the U.S. Food and Drug Administration) 921 Must return to office or clinic for misoprostol administration; can be used only up to 49 days of gestation Up to 49 days Mifepristone 200 mg orally, followed by misoprostol 800 micrograms vaginally, buccally, or sublingually 24-48 hours later (alternative evidence-based regimens; with vaginal administration, misoprostol may be administered 6 hours or less after mifepristone) 95-992-7 Compared with the regimen approved by the Food and Drug Administration: More effective Less time to expulsion Fewer adverse effects Lower cost More convenient because allows home administration of misoprostol Up to 63 days Methotrexate, 50 mg/m2intramuscularly or 50 mg vaginally plus misoprostol, 800 micrograms vaginally 3-7 days later 92-968-10 Compared with mifepristone-misoprostol regimen: Takes longer for expulsion in 20-30% of women Readily available medications Low drug cost Up to 49 days Misoprostol only, 800 micrograms vaginally or sublingually administered every 3 hours for three doses (with vaginal administration, dosing interval may be as long as 12 hours) 84-8511 Significantly higher incidence of adverse effects than other regimens Readily available medication Low drug cost Up to 63 days